De la atención de los problemas de la audición y lenguaje a la logopedia como disciplina

Las dificultades del lenguaje han estado presentes en el ser humano desde la antigüedad.La sensibilización social e institucional hacia este tipo de trastornos ha mejorado lentamentehasta nuestros días. Ya en la Edad Moderna (siglos XVI al XVIII) se informa de educación de sujetos con problemas de lenguaje. Destaca el trabajo de Pedro Ponce de León como precursor del tratamiento estas dificultades. De forma progresiva, se tomó conciencia de la importancia del tratamiento de las dificultades del lenguaje. En los siglos XIX y XX se produce la institucionalización de la atención a personas con trastornos del lenguaje. La Orientación Educativa atiende tradicionalmente esta problemática. Posteriormente surgen numerosas publicaciones, revistas especializadas, congresos y, comienza a hablarse de la disciplina de Logopedia en España. Con todo, el presente trabajo pretende poner de manifiesto la evolución significativa que ha experimentado la logopedia como disciplina en el contexto español y su asociación con la Orientación Educativa y la Psicopedagogía. Hablaremos, en la primera parte, de la historia de la logopedia y, en la segunda parte, del nacimiento de la logopedia como titulación oficial

Characteristics of Induced-Sputum Inflammatory Phenotypes in Adults with Asthma : Predictors of Bronchial Eosinophilia

The objectives of this study were, for patients attending a specialist asthma clinic at a tertiary care hospital, to determine, from sputum induction (SI), proportions of bronchial inflammatory phenotypes, demographic, clinical and functional characteristics of each phenotype, and the most accessible non-invasive inflammatory marker that best discriminates between phenotypes. Included were 96 patients with asthma, attending a specialist asthma clinic at a tertiary care hospital, who underwent testing as follows: SI, spirometry, fractional exhaled nitric oxide (FeNO), blood eosinophilia, total immunoglobulin E (IgE), and a skin prick test. SI phenotypes were 46.9% eosinophilic, 33.3% paucigranulocytic, 15.6% neutrophilic, and 4.2% mixed. No significantly different clinical or functional characteristics were observed between the phenotypes. A positive correlation was observed between SI eosinophilia and both emergency visits in the last 12 months (p = 0.041; r = 0.214) and FeNO values (p = 0.000; r = 0.368). Blood eosinophilia correlated with SI eosinophilia (p = 0.001; r = 0.362) and was the best predictor of bronchial eosinophilia, followed by FeNO, and total blood IgE (area under the receiver operating characteristic curve (AUC-ROC) 72%, 65%, and 53%, respectively), although precision was only fair. In consultations for severe asthma, the most frequent phenotype was eosinophilic. Peripheral blood eosinophilia is a reliable marker for discriminating between different bronchial inflammatory phenotypes, is useful in enabling doctors to select a suitable biologic treatment and so prevent asthma exacerbation, and is a better predictor of bronchial eosinophilia than FeNO and IgE values

Calidad microbiológica y resistencia a antimicrobianos de Escherichia coli y Staphylococcus aureus aislados a partir de queso “Arzúa-Ulloa” convencional y ecológico

The presence of Escherichia coli, Staphylococcus aureus, Listeria monocytogenes and Salmonella spp. was tested in 184 cheese samples included in the Protected Designation of Origin ‘‘Arzu´a-Ulloa’’. From these samples, 57 were raw-milk conventional cheese (RCC), 67 were pasteurized-milk conventional cheese (PCC) and the remaining 60 were pasteurized-milk organic cheese (POC). From these samples, a total of 287 E. coli and 281 S. aureus isolates were analyzed by an agar disk diffusion assay for their resistance to 11 antimicrobial agents. No significant differences were seen in microbiological general acceptance according to European Regulation 2073/2005. Only L. monocytogenes showed unsatisfactorily high levels in RCC samples as compared to PCC (P ¼ 0.0334) and POC (P ¼ 0.0138) samples. Although it was found that both E. coli and S. aureus isolated from POC samples showed lower resistance to some antimicrobials than isolates from RCC and/or PCC, for other antimicrobials higher resistance rates were found for POC isolates than conventional ones. Thus, the differences in antimicrobial resistance were too ambiguous to recommend a higher use of antimicrobials in conventional dairy herds than in organic onesLa presencia de Escherichia coli, Staphylococcus aureus, Listeria monocytogenes y Salmonella spp fue investigada en 184 quesos pertenecientes a la denominación de origen ‘‘Arzúa-Ulloa’’. De estas muestras, 57 correspondieron a quesos fabricados a partir de leche cruda convencional (RCC), 67 correspondieron a quesos fabricados a partir de leche pasteurizada convencional (PCC), y las restantes 60 muestras correspondieron a quesos fabricados a partir de leche pasteurizada ecológica (POC). A partir de dichas muestras, se aislaron un total de 287 cepas de E. coli y 281 de S. aureus y posteriormente se investigó la resistencia a 11 antimicrobianos de estas cepas mediante el método de difusión en agar. No se encontraron diferencias significativas en la aceptabilidad microbiológica de acuerdo a lo establecido en el Reglamento Europeo 2073/2005. Sólo en el caso de L. monocytogenes, se observó una mayor de proporción de muestras inaceptables en RCC con respecto a PCC (P ¼ 0,0334) y POC (P ¼ 0,0138). Aunque tanto los E. coli como los S. aureus aislados a partir de POC mostraron menores tasas de resistencia a algunos antimicrobianos que las cepas aisladas a partir de RCC y/o PCC, en el caso de otros antimicrobianos se encontró una mayor tasa de resistencia que en las muestras procedentes de leche convencional. Por lo tanto, las diferencias encontradas en la resistencia a antimicrobianos en función del tipo de leche utilizado en la fabricación del queso resultaron demasiado ambiguas para demostrar un mayor uso de antimicrobianos en la producción de leche convencional que en el caso de la ecológicaThe authors are thankful for financial support from Dirección Xeral de Ordenación e Calidade do Sistema Universitario de Galicia, Consellería de Educación e Ordenación Universitaria-Xunta de GaliciaS

Validation of the long-term assessment of hypothalamic-pituitary-adrenal activity in rats using hair corticosterone as a biomarker

The evaluation of chronic activity of the hypothalamic-pituitary-adrenal (HPA) axis is critical for determining the impact of chronic stressful situations. However, current methods have important limitations. The potential use of hair glucocorticoids as a noninvasive retrospective biomarker of long-term HPA activity is gaining acceptance in humans and wild animals. However, there is no study examining hair corticosterone (HC) in laboratory animals. The present study validates a method for measuring HC in rats and demonstrates that it properly reflects chronic HPA activity. The HC concentration was similar in male and female rats, despite higher total plasma corticosterone levels in females, tentatively suggesting that it reflects free rather than total plasma corticosterone. Exposure of male rats to 2 different chronic stress protocols (chronic immobilization and chronic unpredictable stress) resulted in similarly higher HC levels compared to controls (1.8-fold). HC also increased after a mild chronic stressor (30 min daily restraint). Chronic administration of 2 different doses of a long-acting ACTH preparation dramatically increased HC (3.1- and 21.5-fold, respectively), demonstrating that a ceiling effect in HC accumulation is unlikely under other more natural conditions. Finally, adrenalectomy significantly reduced HC. In conclusion, HC measurement in rats appears appropriate to evaluate integrated chronic changes in circulating corticosterone

Asthma with bronchial hypersecretion : expression of mucins and toll-like receptors in sputum and blood

1) Define the clinical and inflammatory phenotype of asthma with bronchial hypersecretion of mucus. 2) Compare the type of mucin present in induced sputum (IS) of patients with and without bronchial hypersecretion. 3) Determine the expression of TLRs in IS and blood of asthmatics with and without bronchial hypersecretion. Cross-sectional study which included 43 non-smoking asthmatic patients without bronchiectasis, 19 with bronchiectasis, and 24 without bronchial hypersecretion. All patients underwent the following: IS, spirometry, fractional exhaled nitric oxide, prick test, total immunoglobulin E (IgE), and blood albumin. Analysis of mucins was determined by ELISA and expression of TLR2 and TLR4 by flow cytometry. The level of asthma control was determined by the Asthma Control Test (ACT) questionnaire and quality of life was assessed by the reduced version of the Asthma Quality of Life Questionnaire (mini-AQLQ). Asthmatics with bronchial hypersecretion were significantly older (62.6 years vs 48.5 years; p =0.02); had greater severity (persistent severe asthma 94.7% vs 29.2%; p =0.000); a higher proportion of nasal polyposis (36.8% vs 8.3%; p =0.022); less control of asthma (73.7% vs 8.3%; p =0,000); a higher proportion of asthma with negative prick test (68.4% vs 16.6%; p =0.001), and lower levels of IgE (113.4 IU/mL vs 448 IU/mL; p =0.007), compared with asthmatics without bronchial hypersecretion. Significant differences were observed neither in the expression of TLRs 2 and 4 in inflammatory cells of IS or peripheral blood, nor in the expression of mucins between both groups. Asthma patients with bronchial hypersecretion have more severe and uncontrolled disease, with poor quality of life as well as a non-allergic inflammatory phenotype. Within the mechanisms involving these differences, it does not appear that mucins and TLRs play an important role

Relationship between tobacco, cagA and vacA i1 virulence factors and bacterial load in patients infected by Helicobacter pylori

Background and Aim Several biological and epidemiological studies support a relationship between smoking and Helicobacter pylori (H. pylori) to increase the risk of pathology. However, there have been few studies on the potential synergistic association between specific cagA and vacA virulence factors and smoking in patients infected by Helicobacter pylori. We studied the relationship between smoking and cagA, vacA i1 virulence factors and bacterial load in H. pylori infected patients. Methods Biopsies of the gastric corpus and antrum from 155 consecutive patients in whom there was clinical suspicion of infection by H. pylori were processed. In 106 patients H. pylori infection was detected. Molecular methods were used to quantify the number of microorganisms and presence of cagA and vacA i1 genes. A standardized questionnaire was used to obtain patients’ clinical data and lifestyle variables, including tobacco and alcohol consumption. Adjusted Odds Ratios (ORadjusted) were estimated by unconditional logistic regression. Results cagA was significantly associated with active-smoking at endoscope: ORadjusted 4.52. Evidence of association was found for vacA i1 (ORadjusted 3.15). Bacterial load was higher in active-smokers, although these differences did not yield statistical significance (median of 262.2 versus 79.4 copies of H. pylori per cell). Conclusions The association between smoking and a higher risk of being infected by a virulent bacterial population and with higher bacterial load, support a complex interaction between H. pylori infection and environmental factors

Хирургическое лечение холециститов и их осложнений

ЖЕЛЧНОКАМЕННАЯ БОЛЕЗНЬЖЕЛЧНЫХ ПУТЕЙ БОЛЕЗНИПЕЧЕНИ БОЛЕЗНИХИРУРГИЯ ЖЕЛЧНЫХ ПУТЕЙХИРУРГИЯ ПЕЧЕНИХОЛЕЦИСТИТКурс лекций включает в себя 8 лекций, посвященных анатомическим сведениям о желчевыводящих путях, этиопатогенезу острого и хронического холецистита. Освещены современные методы диагностики заболевания желчевыводящих путей, приведена клиническая картина различных форм острого холецистита, включая поражения желчевыводящих путей, хирургическая тактика, способы хирургических вмешательств, ошибки в хирургии желчевыводящих путей, постхолецистэктомический синдром

Revista iberoamericana de educación

Resumen basado en el de la publicaciónTítulo, resumen y palabras clave en español e inglésNúmero especial que acompaña al monográfico "Los modelos de gestión en los centros educativos de Iberoamérica. Retos y posibilidades"Las dificultades del lenguaje han estado presentes en el ser humano desde la antigüedad. La sensibilización social e institucional hacia este tipo de trastornos ha mejorado lentamente hasta nuestros días. Ya en la Edad Moderna (siglos XVI al XVIII) se informa de educación de sujetos con problemas de lenguaje. De forma progresiva, se tomó conciencia de la importancia del tratamiento de las dificultades del lenguaje. En los siglos XIX y XX se produce la institucionalización de la atención a personas con trastornos del lenguaje. La Orientación Educativa atiende tradicionalmente esta problemática. Con todo, Se pretende poner de manifiesto la evolución significativa que ha experimentado la logopedia como disciplina en el contexto español y su asociación con la Orientación Educativa y la Psicopedagogía. Se trata, en la primera parte, de la historia de la logopedia y, en la segunda parte, del nacimiento de la logopedia como titulación oficial.ES